The focus of the paper is on those information systems that record the experience of patients in acute, community and mental health trusts (NHS trusts) in England. These systems have for some years fed into a national database (the Hospital Episode Statistics database), and their development has been strongly influenced by the information demands of the Department of Health. As a result, they form the largest comprehensive set of patient-based information available to the NHS and the starting point for most attempts to monitor and compare the performance of different trusts.
It follows that the paper is directed primarily at the directors and senior managers of secondary care trusts. Some trusts have already made the quality of patient-based information a corporate concern; others need to do the same. Improvement requires the active involvement not only of the chief executive but also of non-executives and other directors, and of clinicians and managers who - whether or not they have yet become involved with data quality issues - ultimately generate and should be making use of the information that exists.
The paper will also be of interest to directors and senior managers of the new strategic health authorities and of PCTs. Between April and October 2002, strategic health authorities will (subject to legislation) take over responsibility for the performance management of NHS trusts; at the same time, PCTs will expand their commissioning role, while remaining providers of many primary and community health services. PCTs will be particularly concerned to ensure that the comprehensive patient-based records they will be developing are based on sound data. The Commission's research, including reviews recently undertaken by auditors, also contains messages for those responsible for the central direction of efforts to improve NHS information systems - the Information Policy Unit of the Department of Health and the NHS Information Authority.